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Individual

MR. WESLEY JAY MOONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.P.A.

Contact information

Practice address
5509 MONROE RD, SUITE 203, CHARLOTTE, NC 28212-5503
(704) 535-4143
(704) 568-8927
Mailing address
5509 MONROE RD, SUITE 203, CHARLOTTE, NC 28212-5503
(704) 535-4143
(704) 568-8927

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1437
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6107231
NC
Enumeration date
05/25/2007
Last updated
07/24/2013
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